Tag Archives: learning environment

The Benefits of Learner-Centered Teaching

Jaclyn E. Welles
Cell & Molecular Physiology PhD Candidate
Pennsylvania State University – College of Medicine

In the US, Students at Still Facing Struggles in the STEMs

Literacy in the World Today:
According to the United Nations Educational, Scientific, and Cultural Organization (UNESCO), there are approximately 250 million individuals worldwide, who cannot read, write, or do basic math, despite having been in school for a number of years (5, 8). In fact, UNESCO, is calling this unfortunate situation a “Global Learning Crisis” (7). The fact that a significant number of people are lacking in these fundamental life skills regardless of attending school, shows that part of the problem lies within how students are being taught.

Two Main Styles of Teaching – Learner or Teacher-Centered

Learning and Teaching Styles:
It was due to an early exposure to various education systems that I was able to learn of that there were two main styles of teaching – Learner-centered teaching, and Teacher-centered teaching (2). Even more fascinating, with the different styles of teaching, it has become very clear that there are also various types of learners in any given classroom or lecture setting (2, 6, 10). Surprisingly however, despite the fact that many learners had their own learning “modularity” or learning-style, instructors oftentimes taught their students in a fixed-manner, unwilling or unable to adapt or implement changes to their curriculum. In fact, learner-centered teaching models such as the “VARK/VAK – Visual Learners, Auditory Learners and Kinesthetic Learners”, model by Fleming and Mills created in 1992 (6), was primarily established due to the emerging evidence that learners were versatile in nature.

VARK Model of Learners Consists of Four Main Types of Learners: Visual, Auditory, Reading and Writing, and Tactile/Kinesthetic (touch)

What We Can Do to Improve Learning:
The fundamental truth is that when a student is unable to get what they need to learn efficiently, factors such as “learning curves” – which may actually be skewing the evidence that students are struggling to learn the content, need to be implemented (1, 3). Instead of masking student learning difficulties with curves and extra-credit, we can take a few simple steps during lesson-planning, or prior to teaching new content, to gauge what methods will result in the best natural overall retention and comprehension by students (4, 9). Some of methods with evidence include (2, 9):

  • Concept Maps – Students Breakdown the Structure or Organization of a Concept
  • Concept Inventories – Short Answer Questions Specific to a Concept
  • Self-Assessments – Short Answer/Multiple Choice Questions
  • Inquiry-Based Projects – Students Investigate Concept in a Hands-On Project

All in all, by combining both previously established teaching methodologies with some of these newer, simple methods of gauging your students’ baseline knowledge and making the necessary adjustments to teaching methods to fit the needs of a given student population or class, you may find that a significant portion of the difficulties that can occur with students and learning such as – poor comprehension, retention, and engagement, can be eliminated (4, 9) .

Jaclyn Welles is a PhD student in Cellular and Molecular Physiology at the Pennsylvania State University – College of Medicine. She has received many awards and accolades on her work so far promoting outreach in science and education, including the 2019 Student Educator Award from PSCoM.

Her thesis work in the lab of Scot Kimball, focuses on liver physiology and nutrition; mainly how nutrients in our diet, can play a role in influencing mRNA translation in the liver. 

Do You Want To Be On TV?

Last summer, some colleagues and I published a paper on how high school students can communicate their understanding of science through songwriting.  This gradually led to a press release from my home institution, and then (months later) a feature article in a local newspaper, and then appearances on Seattle TV stations KING-5 and KOMO-4.

It’s been an interesting little journey.  I haven’t exactly “gone viral” — I haven’t been adding hundreds of new Twitter followers, or anything like that — but even this mild uptick in interest has prompted me to ponder my relationship with the news media. In short, I do enjoy the attention, but I also feel some responsibility to influence the tone and emphases of these stories. In this post, I share a few bits of advice based on my recent experiences, and I invite others to contribute their own tips in the comments section.

(1) Find out how your school/department/committee views media appearances.  In April, I was invited to appear on KING’s mid-morning talk show, which sounded cool, except that the show would be taped during my normal Thursday physiology lecture!  My department chair and my dean encouraged me to do the show, noting that this sort of media exposure is generally good for the school, and so, with their blessing, I got a sub and headed for the studio.

(2) Respect students’ privacy during classroom visits.  After some students were included in a classroom-visit video despite promises to the contrary, I realized that I needed to protect their privacy more strongly. I subsequently established an option by which any camera-shy students could live-stream the lecture until the TV crew left.

(3) Anticipate and explicitly address potential misconceptions about what you’re doing.  I’ve worried that these “singing professor” pieces might portray the students simply as amused audience members rather than as active participants, so, during the classroom visits, I’ve used songs that are conducive to the students singing along and/or analyzing the meaning of the lyrics. (Well, mostly. “Cross-Bridges Over Troubled Water” wasn’t that great for either, but I had already sung “Myofibrils” for KING, and KOMO deserved an exclusive too, right?)

(4) Take advantage of your institution’s public relations expertise.  Everett Community College’s director of public relations offered to help me rehearse for the talk show — and boy am I glad that she did!  Being familiar with the conventions and expectations of TV conversations, Katherine helped me talk much more pithily than I normally do. In taking multiple cracks at her practice question about “how did you get started [using music in teaching]?” I eventually pared a meandering 90-second draft answer down to 30 seconds. She also asked me a practice question to which my normal response would be, “Can you clarify what you mean by X?” — and convinced me that in a 4-minute TV conversation, you don’t ask for clarifications, you just make reasonable assumptions and plow ahead with your answers.

(5) Ask your interviewers what they will want to talk about. Like a novice debater, I struggle with extemporaneous speaking; the more I can prepare for specific questions, the better.  Fortunately, my interviewers have been happy to give me a heads-up about possible questions, thus increasing their chances of getting compelling and focused answers.

Readers, what other advice would you add to the above?

Gregory J. Crowther, PhD has a BA in Biology from Williams College, a MA in Science Education from Western Governors University, and a PhD in Physiology & Biophysics from the University of Washington. He teaches anatomy and physiology in the Department of Life Sciences at Everett Community College. His peer-reviewed journal articles on enhancing learning with content-rich music have collectively been cited over 100 times.

The Teaching of Basic Science as a Necessity in the Doctor in Physical Therapy Clinical Curriculum

There is an ever increasing need to train evidenced-based clinicians among all the health disciplines. This is particularly true in the relatively young profession of physical therapy, where the educational standards have shifted from entry level bachelor’s degree requirements to clinical doctorate training. The increase in educational standards reflect the growth of the discipline, with an effort to increase the depth of knowledge and level of skill required to be a physical therapist while moving from technician to an independent direct access practitioner. This evolution also marks a shift in standards of evidenced-based practice from clinical observation to an ability to provide mechanistic understanding which includes fundamental scientific insights and transforms clinical practice. The profession also recognizes the need to advance the profession through research that provides a scientific basis validating physical therapy treatment approaches. As a result, there is an expanding, yet underappreciated role, for the basic science researcher / educator in Doctor of Physical Therapy (DPT) programs.

Strategies to integrate and infuse the basic science into practice:

1. Faculty training:

Big Four Bridge in Louisville, KY

How to bridge the gap between basic science and clinical education?  As dual credentialed physical therapist and basic scientist these influence Sonja’s teaching approach, to serve as a “bridge” between foundational science content and clinical application.  Teaching across broad content areas in a DPT curriculum provides opportunities to “make the connection” from what students learn in the sciences, clinical courses, and relate these to patient diagnosis and therapeutic approaches.

While dual training is one approach, these credentials combined with years of ongoing contemporary clinical practice, are rare and impractical to implement in an academic setting. Most often DPT programs rely on PhD trained anatomists, neuroanatomists, and physiologists to teach foundational courses, often borrowed from other departments to fulfill these foundational teaching needs. Thus, Chris’s approach is through crosstalk between scientist/physiologist and clinician to serve as a role model and teach the application of discoveries for identifying best evidence in clinical decision making. By either approach, we have become that key bridge teaching and demonstrating how foundational science, both basic and applied impact clinical decision making.

2. Placement of foundational science courses (physiology, neuroscience, anatomy):

Traditional curricular approaches introduce foundational sciences in anatomy, neuroscience, and physiology in the first year of the DPT curriculum, followed by clinical content with either integrated or end loaded clinical experiences over the course of remaining 2.5-3 years. Our current program established an alternative approach of introducing foundational sciences after the introduction of clinical content and subsequently followed by a full time clinical clerkship/ education. Having taught in both models, early or late introduction of foundational sciences, we recognized either partitioned approaches lead to educational gaps and makes bridging the knowledge to application gap challenging for students.

Regardless, the overall message is clear and suggestive of the need for better integration of foundational/scientific content throughout the curriculum. These challenges are not unique to physical therapy, as this knowledge to clinical translation gap is well documented in medicine and nursing and has been the impetus for ongoing curriculum transformations in these programs. These professions are exploring a variety of approaches on how to best deliver /package courses / and curriculum that foster rapid translation into clinical practice. Arena, R., et al., 2017; Fall, L.H. 2015; Newhouse, R.P. and Spring, B., 2010; Fincher et al., 2009.

Recently, new curricular models have emerged within the doctoral of physical therapy curriculum that complement the academic mission to train competent evidenced based clinicians Bliss et al., 2018, Arena R. et al. 2017. These models leverage the faculty expertise of physiologist/scientist, research, and clinical faculty to create integrative learning experiences for students. These models include integrated models of clinical laboratory learning and/ or classroom-based discussion of case scenarios, that pair the basic scientist and the clinical expert. It is our belief, that teaching our clinical students through these models will lead to enhanced educational experience, application of didactic course work, and the appreciation for high quality research both basic and applied.

3. Appreciation and value of foundational sciences through participation in faculty led research:

Capstone experiences are common curricular elements for the physical therapy profession. This model is believed to 1) prepare future physical therapy generations to provide high-quality clinical care and, 2) provide research needed to guide evidence-based care, and 3) foster the appreciation for evidence and advances in the field. We believe these pipeline experiences could allow for advanced training incorporating strong foundational (science) knowledge that is relevant to the field, which can be applied broadly and adapted to integrate the rapidly growing knowledge base. Such models may assist in integrating the importance of scientific findings (basic and applied) while facilitating the breakdown of barriers (perceived and real) that silo clinical and foundational content (Haramati, A., 2011).

Contributing to the barriers are that relatively few of the basic sciences and translational studies are being conducted by rehabilitation experts. Furthermore, like medicine disciplines, it is unlikely that DPT faculty will be experts as both a clinician and scientist. Rather these emerging models promote teams of scientists and clinical faculty who work together to promote scientific, evidence-based education (Polancich S. et al., 2018; Read and Ward 2017; Fincher et al., 2009). Implementation of these education models requires “buy in” from administration and faculty who must recognize and value a core of outstanding clinician-educators, clinician-scientists, and basic scientists, and reward effective collaboration in education (Fincher 2009).

Although these models are flowering in research intensive universities, the challenges of integrating the basic sciences are greater in programs embedded within smaller liberal arts institutions that lack the infrastructure and administrative support for creating teaching-science-clinical synergies. Often these programs are heavily weighted towards clinical education faculty who emphasize clinical teaching and development of clinical skills, with a less integrated emphasis on the fundamental science in clinical decision making. Our own experience, having taught foundational (physiology and neuroscience) sciences, are that faculty in these programs are more reluctant to embrace and value foundational sciences. A possible explanation may be the limited exposure to and unrecognized value of contributions to the field from such basic and translational approaches. It is frequently implied if it works, it may not be necessary to understand mechanistically how it works. While this might suffice for today’s practice approach, this will not be enough for future clinicians in a rapidly evolving clinical environment. Programs that may not foster scientific curiosity, may be missing the opportunity to instill lifelong learning. We agree with other educators that the integration of basic science is critical for the student progress toward independence and essential competence, and that health science educators should support the teaching of basic science as it aids in the teaching of how to solve complex clinical scenarios even if clinicians may not emphasize the basic science that underlies their reasoning (Pangaro, 2011).

Concluding Thoughts:

Physical therapy departments particularly those within major academic centers housing a mix of research, education, and clinically focused faculty can successfully operate a curriculum able to synergize education, research, and clinical initiatives. Creating synergies early in a curriculum by pairing clinical specialists with science trained faculty will facilitate connections between clinical practice and science (Bliss, et al., 2018). While curricular change can be challenging, programs that implement a collaborative model where faculty with a shared area of expertise (e.g., orthopedics, neurology, cardiopulmonary, pediatrics and geriatrics) and unique complementary skill sets (i.e., research, education, and clinical practice) come together to transform student educational experiences – completing that bridge between basic science and clinical practice.

Stacked Stone Arch

 

References:

Arena, R., Girolami, G., Aruin, A., Keil, A., Sainsbury, J. and Phillips, S.A.,

Integrated approaches to physical Therapy education: a new comprehensive model from the University of Illinois Chicago, Physiotherapy Theory and Practice, 2017, 33:5, 353-360, doi: 10.1080/09593985.2017.1305471.

Bliss, R., Brueilly, K. E., Swiggum, M. S., Morris, G. S., Williamson, E.M., Importance of Terminal Academic Degreed Core Faculty in Physical Therapist Education, Journal of Physical Therapy Education. 2018, 32(2):123-127, doi: 10.1097/JTE.0000000000000054.

Fall, L.H., The Collaborative Construction of the Clinical Mind: Excellence in Patient Care through Cognitive Integration of Basic Sciences Concepts into Routine Clinical Practice, Med.Sci.Educ. 2015, 25(Suppl 1): 5, doi: 10.1007/s40670-015-0192-9.

Fincher, M., Wallach P., and Richardson, W.S.,  Basic Science Right, Not Basic Science Lite: Medical Education at a Crossroad, J Gen Intern Med. 2009, Nov; 24(11): 1255–1258, doi: 10.1007/s11606-009-1109-3

Haramati, A., Fostering Scientific Curiosity and Professional Behaviors in a Basic Science Curriculum, Med.Sci.Educ. 2011, 21(Suppl 3): 254, doi: 10.1007/BF03341720.

Newhouse, R.P. and Spring, B., Interdisciplinary Evidence-based Practice: Moving from Silos to Synergy, Nurs Outlook. 2010, Nov–Dec; 58(6): 309–317, doi: 10.1016/j.outlook.2010.09.001.

Pangaro, L., The Role and Value of the Basic Sciences in Medical Education: The Perspective of Clinical Education -Students’ Progress from Understanding to Action. Medical Science Educator. 2010, Volume 20: No. 3. 307-313.

Polancich, S., Roussel, L., Graves, B.A., O’Neal, P.V., A regional consortium for doctor of nursing practice education: Integrating improvement science into the curriculum. J Prof Nurs. 2017, Nov – Dec;33(6):417-421, doi: 10.1016/j.profnurs.2017.07.013.

Read C.Y., Ward L.D., Misconceptions About Genomics Among Nursing Faculty and Students. Nurse Educ. 2018, Jul/Aug;43(4):196-200, doi: 10.1097/NNE.0000000000000444.

 

 

Chris Wingard completed his BA in Biology form Hiram College a MS from University of Akron and PhD from Wayne State University. He has served in physiology departments at University of Virginia, Medical College of Georgia and East Carolina University during his career and has most recently joined the Bellarmine University College of Health Professions as Professor teaching in the Physical Therapy, Accelerated Nursing and Biology Programs.  His interests are in the impacts of environmental exposures on the function of the cardiovascular pulmonary systems.
Sonja Bareiss received a BS in Biology and Master’s in Physical Therapy from Rockhurst University. She completed her PhD in Anatomy and Cell Biology at East Carolina University. Dr. Bareiss was a faculty member at East Carolina University Department of Physical Therapy and Department of Anatomy and Cell Biology before joining the DPT program at Bellarmine University. Her areas of teaching span foundational sciences (neuroscience and anatomy) to clinical content (electrical modalities). Her most recent efforts have been to develop and implement a pain mechanisms and management course into physical therapy curriculum with emphasis on interdisciplinary learning. In addition to her academic experience, Dr. Bareiss has over 8 years of full-time clinical experience where she specialized in treating patients with chronic pain syndromes. Her research and clinical interests have been dedicated to understanding mechanisms of neural plasticity related to the development and treatment of pain and neurodegenerative disease and injury and integrating undergraduate Biology Honors and DPT students into the work.
It was Just a Bag of Candy, but Now It’s a Lung – Don’t Be Afraid to Improvise When Teaching Physiology

Many of us have been teaching the same course or the same topic in a team-taught course for many years.  I have been teaching the undergraduate Anatomy and Physiology-II (AP-II) course at a community college for four years.  People often ask, “Doesn’t it get old?  Don’t you get bored, teaching the same topic?”  Without hesitation, I answer, “No.” Why?  First, on-going research continually brings new details and insight to nearly every aspect of cell and integrative physiology.  You’re always learning to keep up with the field and modifying lectures to incorporate new concepts.  Second, you truly want your students to learn and enjoy learning and continually seek out ways to teach more effectively.  You try new approaches to improve student learning.  However, the third reason is truly why teaching physiology will never get old or dull.  No two students and no two classes are alike; individual and collective personalities, career goals, academic backgrounds and preparedness, and learning curves vary from class to class.  About half my students have not taken the general biology or chemistry courses typically required for AP-I or AP-II (these are not required by the college).  The unique combination of characteristics in each group of students means that on any given day I will need to create a new makeshift model or a new analogy for a physiological mechanism or structure-function relationship to help students learn.  Thus, even if all physiological research came to complete fruition, the teaching of physiology would still be challenging, interesting, and entertaining.  Many of my peers share this perspective on teaching physiology.

Irrespective of one’s mastery of integrative physiology, as teachers we must be ready and willing to think creatively on our feet to answer questions or clarify points of confusion.  A common mistake in teaching is to interpret the lack of questions to mean our students have mastered the concept we just explained, such as the oxygen-hemoglobin dissociation curve.  Despite the amazing color-coding of green for pH 7.35, red for pH 7.0 and blue for pH 7.5 and perfectly spaced lines drawn on that PowerPoint slide, your Ms./Mr. Congeniality level of enthusiasm, and sincerest intentions – you lost them at “The relationship of oxygen saturation of hemoglobin to the partial pressure of oxygen is curvilinear.”  You know you lost them.  You can see it in their faces.  The facial expression varies: a forehead so furrowed the left and right eyebrows nearly touch, the cringing-in-pain look, the blank almost flat stare, or my favorite – the bug-eyed look of shock.  Unfortunately, it will not always be obvious.  Thus, it is essential we make an effort to become familiar with the class as a group and as individuals, no matter how large the class.  Being familiar with their baseline demeanor and sense of humor is a good start.  (I have students complete ‘Tell Me About Yourself’ cards on the first day of class; these help me a great deal.)  During lecture, we make continual and deliberate eye contact with the students and read their faces as we lecture and talk to them, rather than at them.  In lab we work with and talk to each group of students and even eavesdrop as a means to assess learning.  Time in class or lab is limited, which tempts us to overlook looks of confusion and move on to the next point.  However, when students do not accurately and confidently understand a fundamental concept, they may have even greater difficulty understanding more integrated and complicated mechanisms.  You must recognize non-verbal, as well as subtle verbal cues that students are not following your logic or explanation.  In that immediate moment you must develop and deliver an alternative explanation.  Improvise.

As per Merriam-Webster, to improvise is to compose, recite, play, or sing extemporaneously; to make, invent, or arrange offhand; to fabricate out of what is conveniently on hand.  What do you have on hand right now to create or develop a new explanation or analogy?  Work with what you have within the confines of the classroom.  These resources can be items within arm’s reach, anything you can see or refer to in the classroom.  You can also use stories or anecdotes from your own life.  Reference a TV commercial, TV show, movie, song, or cartoon character that is familiar to both you and your students.  Food, sports, and monetary issues can be great sources for ideas.  I cook and sew, which gives me additional ideas and skills.  Play to your strengths.  Some people are the MacGyvers of teaching; improvisation seems to be a natural born gift.  However, we all have the basic ability to improvise.  You know your topic; you are the expert in the room.  Tap into your creativity and imagination; let your students see your goofy side.  Also, as you improvise and implement familiar, everyday things to model or explain physiological or structure-function relationships you teach your students to think outside the box.  Students learn by example.  My own undergraduate and graduate professors improvised frequently.  My PhD and post-doc advisors were comparative physiologists – true masters of improvised instrumentation.

Improvise now, and improve later.  Some of my improvised explanations and demonstrations have worked; some have fallen flat.  In some cases I have taken the initial improvised teaching tool and improved the prototype and now regularly use the demonstration to teach that physiological concept.  Here are three examples of improvisational analogies I have used for the anatomy of circular folds in the intestine, the opening and closing of valves in the heart, and the role of alveoli in pulmonary gas exchange.  Disclaimer:  These are not perfect analogies and I welcome comments.

Surface area in the small intestine.  Students understand that the surface area of a large flat lab table is greater than the surface area of a flat sheet of notebook paper.  A sheet of paper can be rolled into a tube, and students understand that the surface area of the ‘lumen’ is equal to the surface area of the paper.  In AP-I, students learned that microvilli increase the surface area of the plasma membrane at the apical pole of an epithelial cell, and many teachers use the ‘shag carpet’ analogy for microvilli.  Similarly, they understood how villi increase surface area of the intestinal lumen.  However, some students did not quite understand or cannot envision the structure of circular folds.  As luck would have it, I was wearing that style of knit shirt with extra-long sleeves that extend just to your fingertips.  I fully extended the sleeve and began to explain. “My sleeve is the small intestine – a tube with a flat-surface lumen (my arm is in the lumen) – no circular folds.  This tube is 28 inches long and about 8 inches around.  As I push up my sleeves as far as I can, and the fabric bunches up.  These messy folds that form are like circular folds.  And, now this 6 inch tube with all these circular folds has the same surface area as the 28-inch plain tube.”  (I sew; I know the length of my own arm and am great at eyeballing measurements.)

Heart valves open and close as dictated by the pressure difference across the valve.  This is integral to ventricular filling, ejection of blood into the lung and aorta, and the effect of afterload.  Heart valves are one-way valves.  A few students heard ‘pressure difference’ and were lost.  Other students had trouble understanding how stroke volume would decrease with an increase in afterload.  What can I use in the room?  There’s a big door to the lab, and it has a window.  It opens in one direction – out, because of the doorframe, hinges and door closure mechanism; it only opens, if you push hard enough.  I ran over to the door.  “The lab door is a heart valve.  It’s the mitral valve, the lab is the atrium, and the hallway is the ventricle.  The door only opens into the hall – the mitral valve only opens into the ventricle.  When it closes, it stops once it sits in the frame.”  I asked a student about my size to go outside the room, and push against the door closed – but let me open it; she could see and hear me through the window.  “As long as I push with greater force than she applies to keep it shut, the door or valve will open.”  The student played along and made it challenging, but let me open the door.  ‘Blood flows from the atrium into the ventricle, as long as the valve is open.  But, as soon as the pressure in the ventricle is greater than the pressure in the atrium the valve closes.”  The student forcefully pushed the door shut.  They got it!  Now, afterload …?  Back to the lab door.  “Now the lab door is the aortic valve, the lab is the left ventricle, and the hall is the aorta.  This valve will open and stay open as long as the pressure in the ventricle is greater than the pressure in the aorta.  The longer the valve is open, the greater the volume of blood ejected from the ventricle.  The volume of blood ejected from the ventricle in one beat is the stroke volume.  The pressure that opposes the opening of the aortic valve is afterload.  What happens with afterload?”  I then asked the tallest, strongest student in class to play the role of Afterload; he too got into the role.  “Afterload has now increased!  The pressure that opposes the opening of the valve has increased.  Will I or won’t I have to push harder to open the door – now that afterload has increased?”  The student is very strong; I can barely push the door open.  “I not only have to push harder, but I can’t keep the door or valve open for very long.  Look.  Even though the ventricle pressure is greater, the valve is open for a shorter period – so less blood is ejected and stroke volume decreases.”

Alveoli increase the surface area for gas exchange.  Students see the lungs as 2 large sacs, and the surface area available for gas exchange between air and blood is simply the inner lining of each sac.  However, each lung is made of millions of tiny air sacs or alveoli into which air flows.  How this anatomical arrangement greatly increases surface area for gas exchange is not intuitively obvious.  The overall size of the lung does not increase, so why would the surface area increase?  As luck would have it, it was Halloween.  I had brought a big bonus bag of individually wrapped bite-size candies to class.  “One lung is like this bag.  If we cut open the bag and measure the sheet of plastic, it would be about 18 inches by 12 inches or 216 square inches.  But if we completely fill it with candy, it might hold at least 150 pieces of candy.”  I quickly unwrapped one piece of candy, held up the wrapper, and estimated a single wrapper was 4 square inches.  “If we fill one bag with 150 pieces of candy, we then have 600 square inches of surface area.  Which would provide greater area for gas exchange: one big lung or millions of alveoli?”  I revised this particular improvised explanation using scissors, a ruler and two 11-oz bags of Hershey’s® kisses.  I carefully opened both bags and transferred kisses from one bag to the other, until it was completely full, i.e., 112 kisses, and taped it shut.  I then fully opened up the other bag; it was 10 inches x 8 inches or 80 square inches.  An individual kiss wrapper is 4 square inches; all 112 individual wrappers are 448 square inches.

My improvised analogies are not perfect, but they have served as great teaching tools.  If you can improve upon these, please do.  Share any suggestions you have and lastly, share your improvised explanations and analogies.  Thanks.

Alice Villalobos received her B.S.in biology from Loyola Marymount University and her PhD in comparative physiology from the University of Arizona-College of Medicine.  She has been in the Department of Biology at Blinn College for 4 years where she teaches Anatomy and Physiology II and Introduction to Human Nutrition.  She guest lectures in undergraduate courses at Texas A&M University on the topics of brain barrier physiology and the toxicity of heavy metals.
Mentoring Mindsets and Student Success

There are numerous studies showing that STEM persistence rates are poor (especially amongst under-represented minority, first-generation, and female students) (1-2). It is also fairly broadly accepted that introductory science and math courses act as a primary barrier to this persistence, with their large class size. There is extensive evidence that first-year seminar courses help improve student outcomes and success, and many of our institutions offer those kinds of opportunities for students (3). Part of the purpose of these courses is to help students develop the skills that they need to succeed in college while also cultivating their sense of community at the university.  In my teaching career, I have primarily been involved in courses taken by first-year college students, including mentoring others while they teach first-year courses (4). To help starting to build that sense of community and express the importance of building those college success skills, I like to tell them about how I ended up standing in front of them as Dr. Trimby.

I wasn’t interested in Biology as a field when I started college. I was going to be an Aerospace Engineer and design spaceships or jets, and I went to a very good school with a very good program for doing exactly this. But, college didn’t get off to the best start for me, I wasn’t motivated and didn’t know how to be a successful college student, so my second year of college found me now at my local community college (Joliet Junior College) taking some gen ed courses and trying to figure out what next. I happened to take a Human Genetics course taught by Dr. Polly Lavery. At the time, I didn’t know anything about Genetics or have a particular interest, I just needed the Natural Science credit. Dr. Lavery’s course was active and engaged, and even though it didn’t have a lab associated with it we transformed some E. coli with a plasmid containing GFP and got to see it glow in the dark (which, when it happened almost 20 years ago was pretty freaking cool!). This was done in conjunction with our discussions of Alba the glow-in-the-dark rabbit (5). The course hooked me! I was going to study gene therapy and cure cancer! After that semester, I transferred to Northern Illinois University and changed my major to Biology.

So, why do I bring this up here? When I have this conversation with my undergraduate students, my goal is to remind them that there will be bumps in the road. When we mentor our students, whether it be advisees or students in our classes, it is important to remind them that failure happens. What matters is what you do when things do go sideways. That is really scary for students. Many of our science majors have been extremely successful in the lead up to college, and may have never really failed or even been challenged. What can we do to help our students with this?

First of all, we can build a framework into our courses that supports and encourages students to still strive to improve even if they don’t do well on the first exam. This can include things like having exam wrappers (6)  and/or reflective writing assignments that can help students assess their learning process and make plans for future assessments. Helping students develop self-regulated learning strategies will have impacts that semester (7) and likely beyond. In order for students to persevere in the face of this adversity (exhibit grit), there has to be some sort of hope for the future – i.e. there needs to be a reasonable chance for a student to still have a positive outcome in the course. (8) This can include having a lower-stakes exam early in the semester to act as a learning opportunity, or a course grading scale that encourages and rewards improvement over the length of the semester.

Secondly, we can help them to build a growth mindset (9), where challenges are looked forward to and not knowing something or not doing well does not chip away at someone’s self-worth. Unfortunately, you cannot just tell someone that they should have a growth mindset, but there are ways of thinking that can be encouraged in students (10).

Something that is closely tied to having a growth mindset is opening yourself up to new experiences and the potential for failure. In other words being vulnerable (11). Many of us (and our students) choose courses and experiences that we know that we can succeed at, and have little chance of failure. This has the side effect of limiting our experiences. Being vulnerable, and opening up to new experiences is something important to remind students of. This leads to the next goal of reminding students that one of the purposes of college is to gain a broad set of experiences and that for many of us, that will ultimately shape what we want to do, so it is okay if the plan changes – but that requires exploration.

As an educator who was primarily trained in discipline-specific content addressing some of these changes to teaching can be daunting. Fortunately there are many resources available out there. Some of them I cited previously, but additional valuable resources that have been helpful to me include the following:

  • Teaching and Learning STEM: A Practical Guide. Felder & Brent Eds.
    • Covers a lot of material, including more information of exam wrappers and other methods for developing metacognitive and self-directed learning skills.
  • Cheating Lessons: Learning from Academic Dishonesty by Lang
    • Covers a lot relating to student motivation and approaches that can encourage students to take a more intrinsically motivated attitude about their learning.
  • Rising to the Challenge: Examining the Effects of a Growth Mindset – STIRS Student Case Study by Meyers (https://www.aacu.org/stirs/casestudies/meyers)
    • A case study on growth mindset that also asks students to analyze data and design experiments, which can allow it to address additional course goals.

 

  1. President’s Council of Advisors on Science and Technology. (2012). Engage to excel: Producing one million additional college graduates with degrees in science, technology, engineering and mathematics. Washington, DC: U.S. Government Office of Science and Technology.
  2. Shaw, E., & Barbuti, S. (2010). Patterns of persistence in intended college major with a focus on STEM majors. NACADA Journal, 30(2), 19–34.
  3. Tobolowsky, B. F., & Associates. (2008). 2006 National survey of first-year seminars: Continuing innovations in the collegiate curriculum (Monograph No. 51). Columbia: National Resource Center for the First-Year Experience and Students in Transition, University of South Carolina.
  4. Wienhold, C. J., & Branchaw, J. (2018). Exploring Biology: A Vision and Change Disciplinary First-Year Seminar Improves Academic Performance in Introductory Biology. CBE—Life Sciences Education, 17(2), ar22.
  5. Philipkoski, P. RIP: Alba, The Glowing Bunny. https://www.wired.com/2002/08/rip-alba-the-glowing-bunny/. Accessed January 23, 2019.
  6. Exam Wrappers. Carnegie Mellon – Eberly Center for Teaching Excellence. https://www.cmu.edu/teaching/designteach/teach/examwrappers/ Accessed January 23, 2019
  7. Sebesta, A. and Speth, E. (2017). How Should I Study for the Exam? Self-Regulated Learning Strategies and Achievement in Introductory Biology. CBE – Life Sciences Education. Vol. 16, No. 2.
  8. Duckworth, A. (2016). Grit: The Power of Passion and Perseverance. Scribner.
  9. Dweck, C. (2014). The Power of Believing that you can Improve. https://www.ted.com/talks/carol_dweck_the_power_of_believing_that_you_can_improve?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare
  10. Briggs, S. (2015). 25 Ways to Develop a Growth Mindset. https://www.opencolleges.edu.au/informed/features/develop-a-growth-mindset/. Accessed January 23, 2019.
  11. Brown, B. (2010). The Power of Vulnerability. https://www.ted.com/talks/brene_brown_on_vulnerability?language=en&utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare
Christopher Trimby is an Assistant Professor of Biology at the University of Delaware in Newark, DE. He received his PhD in Physiology from the University of Kentucky in 2011. During graduate school he helped out with teaching an undergraduate course, and discovered teaching was the career path for him. After graduate school, Chris spent four years teaching a range of Biology courses at New Jersey Institute of Technology (NJIT), after which he moved to University of Wisconsin-Madison and the Wisconsin Institute for Science Education and Community Engagement (WISCIENCE – https://wiscience.wisc.edu/) to direct the Teaching Fellows Program. At University of Delaware, Chris primarily teaches a version of the Introductory Biology sequence that is integrated with General Chemistry and taught in the Interdisciplinary Science Learning Laboratories (ISLL – https://www.isll.udel.edu/). Despite leaving WISCIENCE, Chris continues to work on developing mentorship programs for both undergraduates interested in science and graduate students/post-docs who are interested in science education. Chris enjoys building things in his workshop and hopes to get back into hiking more so he can update his profile pic. .
Creating Unique Learning Opportunities by Integrating Adaptive Learning Courseware into Supplemental Instruction Sessions

Teaching a large (nearly 400 students), introductory survey course in human anatomy and physiology is a lot like trying to hit a constantly moving target. Once you work out a solution or better path for one issue, a new one takes its place. You could also imagine a roulette wheel with the following slots: student-faculty ratios, student preparation, increasing enrollments, finite resources, limited dissection specimen availability (e.g., cats), textbook prices, online homework, assessment, adaptive courseware, core competencies, learning outcomes, engagement, supplemental instruction, prerequisites, DFW rates, teaching assistants, Dunning Kruger effect, open educational resources, GroupMe, student motivation, encouraging good study habits, core concepts, aging equipment … and the list goes on.

If the ball lands on your slot, are you a winner or loser?

Before getting ahead of myself, I need to provide an overview of A&P at the University of Mississippi. Fall semesters start with 390 students enrolled in A&P I within one lecture section, 13 lab sections at 30 students each, anywhere from 10-13 undergraduate teaching assistants, 2 supplemental instruction (SI) leaders, and at least six, one-hour SI sessions each week. The unusual class size and number of lab sections is the result of maxing out lecture auditorium as well as lab classroom capacities. I am typically the only instructor during the fall (A&P I) and spring (A&P II) terms, while a colleague teaches during the summer terms. The two courses are at the sophomore-level and can be used to fulfill general education requirements. There are no prerequisites for A&P I, but students must earn a C or better in A&P I to move on to A&P II. Approximately one-third of the students are allied health (e.g., pre-nursing) and nutrition majors, one-third are exercise science majors, and the remaining one-third of students could be majoring in anything from traditional sciences (e.g., Biology, Chemistry, etc.) to mathematics or art.

The university supports a Supplemental Instruction program through the Center for Excellence in Teaching and Learning (https://cetl.olemiss.edu/supplemental-instruction/). The SI program provides an extra boost for students in historically demanding courses such as freshman biology, chemistry, physics, accounting, etc. SI leaders have successfully passed the courses with a grade of B or better, have been recommended to the program by their professors, agree to attend all lectures for the courses in which they will be an SI leader, and offer three weekly, one-hour guided study sessions that are free to all students enrolled in the course. SI leaders undergo training through Center for Excellence in Teaching and Learning and meet weekly with the course professor. Students who regularly attend SI sessions perform one-letter grade higher than students who do not attend SI sessions.

It can be as easy for an instructor to be overwhelmed by the teaching side of A&P as it is for the student to be overwhelmed by the learning side! I know that a major key to student success in anatomy and physiology courses is consistent, mental retrieval practice across multiple formats (e.g., lectures, labs, diagrams, models, dissection specimens, etc.). The more a student practices retrieving and using straightforward information, albeit a lot of it, the more likely a student will develop consistent, correct use. Self-discipline is required to learn that there are multiple examples, rather than one, of “normal” anatomy and physiology. However, few students know what disciplined study means beyond reading the book and going over their notes a few times.

To provide a model for disciplined study that can be used and implemented by all students, I developed weekly study plans for A&P I and II. These study plans list a variety of required as well as optional activities and assignments, many of which are completed using our online courseware (Pearson’s Mastering A&P) and include space for students to write completion dates. If students complete each task, they would spend approximately 10 out-of-class hours in focused, manageable activities such as:

  • Completion of active learning worksheets that correlate to learning outcomes and can be used as flashcards.
  • Practice assignments that can be taken multiple times in preparation for lecture exams and lab practicals.
  • Self-study using the virtual cadaver, photographic atlas of anatomical models, interactive animations of physiological processes, virtual lab experiments, and dissection videos.
  • Regular graded assignments aligned with course learning outcomes.

Weekly study plans are also useful during office visits with students. I can easily assess student progress and identify changes for immediate and long-term improvement. An advantage of using online courseware to support course objectives is the ability to link various elements of the courses (e.g., lecture, lab, SI sessions, online homework, group study, and self-study) with a consistent platform.

All of this sounds like a great sequence of courses, doesn’t it? Yet, the target has kept moving and the roulette wheel has kept spinning. Imagine for the story within this blog that the roulette ball has landed on “using adaptive courseware to improve supplemental instruction.”

In 2016 the University of Mississippi was one of eight universities chosen by the Bill and Melinda Gates Foundation with support of the Association for Public and Land-Grant Universities to increase the use of adaptive courseware in historically demanding general education courses. Thus, began the university’s PLATO (Personalized Learning & Adaptive Teaching Opportunities) Program (https://plato.olemiss.edu/). The PLATO grant provides support for instructors to effectively incorporate adaptive courseware into their courses and personalize learning for all affected students. Administrators of the grant were particularly supportive of instructors who could use adaptive courseware to support the SI sessions. This challenge was my personal roulette ball.

I decided to use diagnostic results from Mastering A&P graded homework assignments to prepare for weekly meetings with SI leaders. Diagnostic data on percent of University of Mississippi students correctly answering each question as well as percent of UM students answering incorrect options are compared to the global performance of all Mastering A&P users. For each question incorrectly answered by more than 50% of the students, I write a short (4-6 sentences) explanation of where students are making errors in expressing or using their knowledge and how to prevent similar errors in the future. I then searched for active learning activities and teaching tips associated with the challenging questions from the LifeSciTRC (https://www.lifescitrc.org/) and Human Anatomy and Physiology Society (HAPS; https://www.hapsweb.org/) websites. I specifically search for active learning exercises that can be conducted in a small, group setting using widely available classroom resources (e.g., white board, sticky notes, the students, etc.).

By using online courseware diagnostics, selecting focused learning activities, and communicating regularly with SI leaders, I was able to create value and unique learning opportunities for each student. The SI session format has been extremely well-received by the students and they immediately see the purpose in the study session experience. The best part is that it takes me only 30-40 minutes each week to write up explanations for the diagnostics and find the best learning activities.

I would say that we are all winners with this spin of the wheel.

Carol Britson received her B.S. from Iowa State University and her M.S. and Ph.D. from the University of Memphis. She has been in the Department of Biology at the University of Mississippi for 22 years where she teaches Vertebrate Histology, Human Anatomy, Introductory Physiology, and Human Anatomy and Physiology I and II. In 2018 she received the University of Mississippi Excellence in Teaching award from the PLATO (Personalized Learning & Adaptive Teaching Opportunities) Program supported by the Association of Public and Land-Grant Universities and the Bill and Melinda Gates Foundation.
Scientific Literacy: A Challenge, a Task, a Poem

Scientific literacy allows citizens to get involved in issues and ideas related to science as a reflective citizen[1]. A scientifically literate person can:

  1. Recognize, offer and evaluate explanations for a variety of scientific and technological phenomena
  2. Describe and evaluate scientific research and propose ways to answer questions and solve problems following the scientific method
  3. Analyze and evaluate data, concepts and arguments in a variety of contexts, reaching appropriate conclusions for the data received[1]

 

The challenge

Quality education is the key to achieving literate societies. Unfortunately, scientific literacy is generally very low in most developing countries. Results of the PISA tests, for example, reveal that competencies in mathematics and sciences in developing countries are below the average of the countries evaluated[2]. This has enormous consequences for the communities by negatively impacting their political, economic and social decision-making.

 

Figure 1. Performance in mathematics and science of different countries in the 2015 Pisa tests. Images Taken from http://www.oecd.org/pisa/.[2]

 

The task

It is very important to open spaces for the general community in developing countries to learn about the practice of science. Many scientific organizations develop training activities that are usually directed at specialized audiences. For this reason, it is important to highlight the task of scientific associations that are concerned with bringing science to the general community such as the American Physiological Society through events such as PhUn week. In the particular case of Colombia, the Colombian Association for the Advancement of Science (ACAC) organizes every two years a very large science fair “Expociencia” that is visited by more than 40,000 elementary, middle and high school students.

 

These science fairs have several objectives:

  1. Allow students to present the results of scientific projects. Students are exposed to an essential component of science, sharing and communicating research. In addition, they have the opportunity to learn from their peers and receive feedback from more experienced researchers.
  2. Open the doors of academic, governmental or industry laboratories to the community. Visitors have the opportunity to know what scientists do, interact with them, expose their visions about science. In addition, visitors can express doubts they have about different concepts, and sometimes they can find answers to their questions.
  3. Generate academic spaces so that researchers can discuss how to work with the community, address their most pressing needs and communicate their results to the public.

Figure 2. Participation of students in academic activities at Expociencia 2018. Images courtesy of Deiryn Reyes, ACAC.

Recently with the support of the Faculty of Medicine of the Universidad de los Andes, I had the opportunity to participate in Expociencia[3]. It was gratifying to see how the children ran from one side to the other having the opportunity to learn about electronics, physics, programming, biology, medicine and anthropology. These children are like sponges that quickly absorb the information they receive and are willing to ask questions without filtering them through mechanisms that adults have learned. In addition, Expociencia promotes spaces for university students to share their experiences and for a moment to be role models for school students. I believe that many lives are changed thanks to the experience of living science.

 

The poem

In the nineteenth century lived a poet who wrote and translated from other languages several of the best-known stories that are known by children and adults in Colombia. His influence on Colombian literature is similar to that of the Grimm brothers in Europe. The name of this writer was Rafael Pombo. A few weeks ago, thanks to my son, I had the opportunity to learn that he also wrote about the importance of knowledge and science. On this occasion I want to share a personal translation of one of Rafael Pombo´s poems, that can be used to discuss with small children and adults the importance of science in our lives.

 

THE CHILD AND THE OX

Rafael Pombo (1833-1912)

The boy

 

-What do you think about all day

Lying on the grass?

You seem to me a great doctor

Enraptured in his science.

 

The ox

-The science, dear child

It is not what feeds me;

That is the fruit of study,

With what God gives humans.

 

Out thinking for me,

Poor animal, hard enterprise;

I prefer to make thirty furrows

Before learning two letters.

 

Chewing well, I care more

that a lesson at school.

With the teeth, I chew,

You, child, with your head.

 

But if you want to be wise

Hopefully seeing me you´ll learn

To ruminate, and ruminate a lot,

Every bit of science.

 

Digesting, not eating,

It is what the body takes advantage of,

And the soul, invisible body,

has to follow such a rule.

 

Without ruminating it well, do not swallow

Not a line, not a letter;

The one who learns like a parrot,

Ignorant parrot stays.

 

References

  1. National Academies of Sciences, E., and Medicine., Science Literacy: Concepts, Contexts, and Consequence. 2016.
  2. OECD. Results by Country. [cited 2018 November 4th]; Available from: http://www.oecd.org/pisa/.
  3. Ciencia, A.C.p.e.A.d.l. Expociencia 2018. 2018 [cited 2018 October 31st]; Available from: https://expociencia.co/home/.
Ricardo A. Peña-Silva M.D., PhD is an associate professor at the Universidad de los Andes, School of Medicine in Bogota, Colombia, where he is the coordinator of the physiology and pharmacology courses for second-year medical students. He received his doctorate in Pharmacology from The University of Iowa in Iowa City. His research interests are in aging, hypertension, cerebrovascular disease and medical education. He works in incorporation and evaluation of educational technology in biomedical education.

He enjoys spending time with his kids. Outside the office he likes running and riding his bicycle in the Colombian mountains.

 

 

 

Questioning How I Question

For some, “assessment” is sometimes a dirty word, with visions of rubrics, accreditation reports, and piles of data.  Readers of this blog hopefully do not have this vantage point, thanks in part to some great previous posts on this topic and an overall understanding of how assessment is a critical component of best practices in teaching and learning.  Yet, even as a new(ish) faculty member who values assessment, I still struggle with trying to best determine whether my students are learning and to employ effective and efficient (who has time to spare?!) assessment strategies.  Thus, when a professional development opportunity on campus was offered to do a book read of “Fast and Effective Assessment: How to Reduce Your Workload and Improve Student Learning” by Glen Pearsall I quickly said “Yes! Send me my copy!”

 

Prior to the first meeting of my reading group, I dutifully did my homework of reading the first chapter (much like our students often do, the night before…).  Somewhat to my surprise, the book doesn’t start by discussing creating formal assessments or how to effectively grade and provide feedback.  Rather, as Pearsall points out “a lot of the work associated with correction is actually generated long before students put pen to paper. The way you set up and run a learning activity can have a profound effect on how much correction you have to do at the end of it.” The foundation of assessment, according to Pearsall is then questioning technique. 

 

Using questions to promote learning is not a new concept and most, even non-educators, are somewhat familiar with the Socratic Method.  While the simplified version of the Socratic Method is thought of as using pointed questions to elicit greater understanding, more formally, this technique encourages the student to acknowledge their own fallacies and then realize true knowledge through logical deduction[1],[2].  Compared to the conversations of Socrates and Plato 2+ millennia ago, modern classrooms not only include this dialectic discourse but also other instructional methods such as didactic, inquiry, and discovery-based learning (or some version of these strategies that bears a synonymous name).  My classroom is no different — I ask questions all class long, to begin a session (which students answer in writing to prime them into thinking about the material they experienced in preparation for class), to work through material I am presenting (in order to encourage engagement), and in self-directed class activities (both on worksheets and as I roam the room).  However, it was not until reading Pearsall’s first chapter that I stopped to question my questions and reflect on how they contribute to my overall assessment strategy.

 

Considering my questioning technique in the context of assessment was a bit of a reversal in thinking.  Rather than asking my questions to facilitate learning (wouldn’t Socrates be proud!), I could consider my questions providing important feedback on whether students were learning (AKA…Assessment!).  Accordingly, the most effective and efficient questions would be ones that gather more feedback in less time.  Despite more focus on the K-12 classroom, I think many of Pearsall’s suggestions[3] apply to my undergraduate physiology classes too.  A brief summary of some strategies for improving questioning technique, separated by different fundamental questions:

 

 

How do I get more students to participate?

  • We can “warm up” cold calling to encourage participation through activities like think-pair-share, question relays, scaffolding answers, and framing speculation.
  • It is important to give students sufficient thinking time through fostering longer wait and pause times. Pre-cueing and using placeholder or reflective statements can help with this.

How do I elicit evidentiary reasoning from students?

  • “What makes you say that?” and “Why is _____ correct?” encourages students to articulate their reasoning.
  • Checking with others and providing “second drafts” to responses emphasizes the importance of justifying a response.

How do I sequence questions?

  • The right question doesn’t necessarily lead to better learning if it’s asked at the wrong time.
  • Questions should be scaffolded so depth and complexity develops (i.e. detail, category, elaboration, evidence).

How do I best respond to student responses?

  • Pivoting, re-voicing, and cueing students can help unpack incorrect and incomplete answers as well as build and explore correct ones.

How do I deal with addressing interruptions?

  • Celebrating good practices, establishing rules for discussion, making it safe to answer and addressing domineering students can facilitate productive questioning sessions.

 

After reviewing these strategies, I’ve realized a few things.  First, I was already utilizing some of these techniques, perhaps unconsciously, or as a testament to the many effective educators I’ve learned from over the years.  Second, I fall victim to some questioning pitfalls such as not providing enough cueing information and leaving students to try their hand at mind-reading what I’m trying to ask more than I would like.  Third, the benefits of better questioning are real.  Although only anecdotal and over a small sampling period, I have observed that by reframing certain questions, I am better able to determine if students have learned and identify what they may be missing.  As I work to clean up my assessment strategies, I will continue to question my questions, and encourage it in my colleagues as well.

 

1Stoddard, H.A. and O’Dell, D.A. Would Socrates Have Actually Used the Socratic Method for Clinical Teaching? J Gen Intern Med 31(9):1092–6. 2016.

2Oyler, D.R. and Romanelli, F. The Fact of Ignorance Revisiting the Socratic Method as a Tool for Teaching Critical Thinking. Am J of Pharm Ed; 78 (7) Article 144. 2014.

3A free preview of the first chapter of Pearsall’s book is available here.

Anne Crecelius (@DaytonDrC) is an Assistant Professor in the Department of Health and Sport Science at the University of Dayton where she won the Faculty Award in Teaching in 2018.  She teaches Human Physiology, Introduction to Health Professions, and Research in Sport and Health Science. She returned to her undergraduate alma mater to join the faculty after completing her M.S. and Ph.D. studying Cardiovascular Physiology at Colorado State University.  Her research interest is in the integrative control of muscle blood flow.  She is a member of the American Physiological Society (APS), serving on the Teaching Section Steering Committee and will chair the Communications Committee beginning in 2019.  In 2018, she was awarded the ADInstruments Macknight Early Career Innovative Educator Award.
Teaching for Learning: The Evolution of a Teaching Assistant

An average medical student, like myself, would agree that our first year in medical school is fundamentally different from our last, but not in the ways most of us would expect. Most of us find out that medical school not only teaches us about medicine but it also indirectly teaches us how to learn. But what did it take? What is different now that we didn’t do back in the first year? If it comes to choosing one step of the road, being a teaching assistant could be a turning point for the perception of medical education in the long run, as it offers a glimpse into teaching for someone who is still a student.

At first, tutoring a group of students might seem like a simple task if it is only understood as a role for giving advice about how to get good grades or how to not fail. However, having the opportunity to grade students’ activities and even listen to their questions provides a second chance at trying to solve one’s own obstacles as a medical student. A very interesting element is that most students refuse to utilize innovative ways of teaching or any method that doesn’t involve the passive transmission of content from speaker to audience. There could be many reasons, including insecurity, for this feeling of superficial review of content or laziness, as it happened for me.

There are, in fact, many educational models that attempt to objectively describe the effects of educating and being educated as active processes. Kirkpatrick’s model is a four-stage approach which proposes the evaluation of specific aspects in the general learning outcome instead of the process as a whole (1). It was initially developed for business training and each level addresses elements of the educational outcome, as follows:

  • Level 1- Reaction: How did learners feel about the learning experience? Did they enjoy it?
  • Level 2- Learning: Did learners improve their knowledge and skills?
  • Level 3- Behavior: Are learners doing anything different as a result of training?
  • Level 4- Results: What was the result of training on the business as a whole?

Later, subtypes for level 2 and 4 were added for inter-professional use, allowing its application in broader contexts like medicine, and different versions of it have been endorsed by the Best Evidence in Medical Education Group and the Royal College of Physicians and Surgeons of Canada (1) (2).  A modified model for medical students who have become teachers has also been adapted (3), grading outcomes in phases that very closely reflect the experience of being a teaching assistant. The main difference is the inclusion of attitude changes towards the learning process and the effect on patients as a final outcome for medical education. The need for integration, association and good problem-solving skills are more likely to correspond to levels 3 and 4 of Kirkpatrick’s model because they overcome traditional study methods and call for better ways of approaching and organizing knowledge.

Diagram 1- Modified Kirkpatrick’s model for grading educational outcomes of medical student teachers, adapted from (3)

These modifications at multiple levels allow for personal learning to become a tool for supporting another student’s process. By working as a teaching assistant, I have learned to use other ways of studying and understanding complex topics, as well as strategies to deal with a great amount of information. These methods include active and regular training in memorization, deep analysis of performance in exams and schematization for subjects like Pharmacology, for which I have received some training, too.

I am now aware of the complexity of education based on the little but valuable experience I have acquired until now as a teacher in progress. I have had the privilege to help teach other students based on my own experiences. Therefore, the role of a teaching assistant should be understood as a feedback process for both students and student-teachers with a high impact on educational outcomes, providing a new approach for training with student-teaching as a mainstay in medical curricula.

References

  1. Roland D. Proposal of a linear rather than hierarchical evaluation of educational initiatives: the 7Is framework. Journal of Educational Evaluation for Health Professions. 2015;12:35.
  2. Steinert Y, Mann K, Anderson B, Barnett B, Centeno A, Naismith L et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Medical Teacher. 2016;38(8):769-786.
  3. Hill A, Yu, Wilson, Hawken, Singh, Lemanu. Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school. Advances in Medical Education and Practice. 2011;:157.

The idea for this blog was suggested by Ricardo A. Pena Silva M.D., Ph.D. who provided guidance to Maria Alejandra on the writing of this entry.

María Alejandra is a last year medical student at the Universidad de Los Andes, School of Medicine in Bogota, Colombia, where she is has been a teaching assistant for the physiology and pharmacology courses for second-year medical students. Her academic interests are in medical education, particularly in biomedical sciences.  She is interested in pursuing a medical residency in Anesthesiology. Outside medical school, she likes running and enjoys literature as well as writing on multiple topics of personal interest.
Why do you teach the way that you do?

Have you ever stopped to think about why you do something the way that you do it? We educators are often very good at describing what we do or have done. I was recently reviewing some CVs for a teaching position; all the CVs were replete with descriptions of what content was taught in which course at which institution. However, I feel that we educators often fail to capture why we teach in a certain way.

 

 

In my extra-curricular life, I am an educator on the soccer field in the form of a coach. Through coaching education, I have been encouraged to develop a philosophy of coaching. This is a description of why I coach the way I do. To develop a coaching philosophy, coaches should think about three central aspects (see: https://www.coach.ca/develop-a-coaching-philosophy-in-3-easy-steps-p159158 for more details):

 

  1. Purpose: why do you coach?

  2. Leadership style – what methods do you use to coach? Are you more ‘coach-centered’ or more ‘player-centered’ in your approach? Or somewhere in between? Why?

  3. Values: what is most important to you? How does it affect the way you coach?

 

If ‘coach’ is replaced by ‘teach’ or ‘teacher’ in the above list, and ‘player’ is replaced by ‘student’, we can use this framework to develop a philosophy of teaching. I have found that putting ‘pen to paper’ in forming a philosophy helps to crystallize your beliefs about teaching that may have been seemingly random, disparate thoughts previously. It can be insightful to synthesize your beliefs about teaching, as it provides some structure and guidance when planning future teaching.

 

It is time to nail my colors to the mast. I teach because I want to help my students be successful diagnosticians in their profession (medicine) and understand why their patient’s bodies are responding in the way that they do in order to help them treat them effectively. I do believe in the benefit of having an expert instructor, especially when you have novice students, so I am probably more teacher-centric than is the current fad. However, I don’t like lectures for the most part, because from my perspective, lectures principally focus on information transfer rather than using and applying the important information. This is not to say that lectures are all bad, but I prefer ‘flipped classroom’ methods that require students to gather the necessary knowledge before class, and then during class, demonstrate mastery of material and apply it to clinical scenarios (with the aid of the instructor). But, that’s me. What about you?

 

If you are applying for positions that will require teaching, having both a teaching philosophy and a teaching portfolio will provide the appropriate evidence to the search committee about how you plan to teach.  The following resources might be useful to you:

Preparing a Teaching Portfolio http://www.unco.edu/graduate-school/pdf/campus-resources/Teaching-Portfolio-Karron-Lewis.pdf

Writing Your Teaching Philosophy https://cei.umn.edu/writing-your-teaching-philosophy

  Hugh Clements-Jewery, PhD is currently Visiting Research Associate Professor at the University of Illinois College of Medicine in Rockford, Illinois. He teaches medical physiology in the integrated Phase 1 undergraduate medical curriculum at the University of Illinois College of Medicine. He is the College-wide leader for the Circulation-Respiration course. He has also recently taken on the role of Director of Phase 1 curriculum at the Rockford campus.